Journal Article

Not all women who experience side effects discontinue their contraceptive method: Insights from a longitudinal study in India

Side effects are a primary reason why women stop using contraception, even though they may still want to avoid a pregnancy. However, women’s experiences with side effects is not well documented, especially among current users. The Demographic and Health Surveys (DHS) and other nationally representative surveys only ask about side effects in the context of discontinuation—women who discontinued a method are asked their reasons for discontinuation, for which side effects is an option. Yet, side effects are also experienced by continued users.

Using longitudinal data collected by the Evidence Project from a cohort of contraceptive users in Odisha and Haryana, India, this article explores the effect of side effect severity and frequency on six-month discontinuation. Half of women who experienced a side effect continued to use their family planning method six months later, and 16% of those who did not experience side effects discontinued their method. Women who experienced moderate/severe side effects infrequently were 67% less likely to discontinue the enrollment method compared to women who experienced moderate/severe side effects always, and women who experienced mild side effects were even less likely to discontinue. Study results suggest that side effect severity and frequency are more important factors than simply the experience of a side effect in understanding contraceptive discontinuation, and national surveys should expand their exploration of side effects to include questions asked of current users.